Nursing Elites

1. When a woman is having her first child, she is experiencing which type of crisis event?

• A. situational
• B. maturational
• C. adventitious
• D. reactive

Correct answer: B

Rationale: A maturational crisis occurs when an individual reaches a new stage of development, such as becoming a parent for the first time, and needs to develop new coping strategies to adapt to this change. Situational crises (Choice A) arise from external sources, not developmental milestones. Adventitious crises (Choice C) are caused by external events like natural disasters and are not related to personal development stages. Reactive crises (Choice D) are responses to specific stressors and are not associated with developmental milestones like becoming a parent for the first time.

2. The LPN is teaching a first-time mother about breastfeeding her newborn. Which statement, if made by the mother, would reflect that the teaching had been successful?

• A. "My baby should be having at least 4-6 wet diapers a day until 1 month."?
• B. "It's nice that breastfed babies eat a bit less than formula-fed babies."?
• C. "My baby should be nursing 8-12 times a day during this period."?
• D. "I'm a little nervous about my milk coming in tomorrow. I've heard it's uncomfortable."?

Correct answer: C

Rationale: The correct answer is, '"My baby should be nursing 8-12 times a day during this period."?' This statement indicates successful teaching because newborns should nurse 8-12 times during the newborn period to ensure they receive adequate nutrition and establish a good milk supply. This frequency helps in meeting the baby's demands for growth and development. Choice A is incorrect because while it mentions the appropriate number of wet diapers a day once the mother's milk comes in, it does not reflect successful teaching about breastfeeding frequency. Choice B is incorrect because it discusses feeding amounts in comparison to formula-fed babies, which is not a direct indicator of successful breastfeeding teaching. Choice D is incorrect because it focuses on the mother's concerns about milk coming in, not on understanding the feeding frequency needed for the newborn.

3. Which of the following is not one of the three universal spiritual needs?

• A. meaning and purpose
• B. love and relatedness
• C. forgiveness
• D. God's permission

Correct answer: D

Rationale: The three universal spiritual needs are meaning and purpose, love and relatedness, and forgiveness. These needs are commonly recognized across various belief systems and cultures. While the concept of God may be central to many religions, 'God's permission' is not considered a universal spiritual need. Seeking 'God's permission' is more specific to certain religious practices rather than a universally acknowledged spiritual need. Therefore, the correct answer is 'God's permission.' Choices A, B, and C are correct as they align with the generally accepted universal spiritual needs.

4. The chemotherapeutic DNA alkylating agents such as nitrogen mustards are effective because they:

• A. cross-link DNA strands with covalent bonds between alkyl groups on the drug and guanine bases on DNA.
• B. have few, if any, side effects.
• C. are used to treat multiple types of cancer.
• D. are cell-cycle-specific agents.

Correct answer: A

Rationale: Alkylating agents, such as nitrogen mustards, are effective chemotherapeutic agents because they cross-link DNA strands with covalent bonds between alkyl groups on the drug and guanine bases on DNA. This cross-linking interferes with DNA replication and transcription, leading to cell death. Choice B is incorrect because alkylating agents have numerous side effects, including alopecia, nausea, vomiting, and myelosuppression. Choice C is incorrect because while nitrogen mustards are used to treat multiple types of cancer like chronic lymphocytic leukemia, non-Hodgkin's lymphoma, and breast and ovarian cancer, their effectiveness is primarily due to DNA cross-linkage. Choice D is incorrect because alkylating agents are non-cell-cycle-specific agents, meaning they can act on cells in any phase of the cell cycle, not just on cells that are actively dividing.

5. A client can receive the mumps, measles, rubella (MMR) vaccine if he or she:

• A. is pregnant.
• B. is immunocompromised.
• C. is allergic to neomycin.
• D. has a cold.

Correct answer: D

Rationale: A client can receive the MMR vaccine if he or she has a cold. A simple cold without fever does not preclude vaccination. Pregnant women and immunocompromised individuals cannot receive the MMR vaccine due to the live rubella component, which may lead to birth defects or disease. Choice C is incorrect because individuals with anaphylactic reactions to neomycin should not receive the measles vaccine according to the American Academy of Pediatrics.

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